Drug Policy Alliance

We read with interest the recent review of medical use of cannabinoids (1). As the authors attempt to emphasize, they focus on a heterogeneous collection of experiments that employed a range of treatments, including synthetic THC, CBD, and THC-mimicking drugs.

Lay readers might inappropriately generalize these results specifically to whole plant medical cannabis But few (only two) of these experiments were conducted using medical cannabis; most of the studies reviewed focused on outcome measures that do not address the plant’s potential advantages over a single, compound agent in pill form.

For example, the authors conclude that evidence of individual, synthetic cannabinoids to help nausea and vomiting due to chemotherapy was low in quality. Within hours of the publication of the paper, mainstream media coverage applied these conclusions to medical cannabis per se, not just medical cannabinoids (2). In fact, as the authors emphasize, only 6 of the 28 studies assessing nausea and vomiting used THC, and none of these actually employed vaporized or inhaled botanical cannabis. The dependent measures were also not sensitive to the key advantage of medical cannabis for nausea: speed of onset. (Inhaled medicines can work within seconds. Sprayed extracts require at least a half hour while cannabinoids in pill form can take multiple hours.) The authors were generally careful about these caveats, but the disparate and inaccurate media coverage suggests that flagship journals in all fields now have to be even more diligent when cautioning readers about the inappropriate generalization of results. Despite increasing popularity, medical cannabis remains controversial and, apparently, newsworthy. As reviews of the effects of cannabinoids proliferate, authors, editors, journal staff, and journalists might welcome a reminder that cautions about interpretation need to be spelled out in more effusive, detailed, and thorough ways.

A new report by the Institute of Taxation and Economic Policy (ITEP) adds considerable information to the base knowledge accumulating at the state level on new changes in laws and custom regarding cannabis legalization circa 2013, starting in the states of Colorado and Washington after citizens voted to end cannabis prohibition via binding ballot initiatives.

Holder: “The war on drugs is now 30, 40 years old. There have been a lot of unintended consequences. There’s been a decimation of certain communities, in particular communities of color.”

“[W]e can certainly change our enforcement priorities, and so we have some control in that way,” Holder said. “How we deploy our agents, what we tell our prosecutors to charge, but I think this would be best done if the executive branch and the legislative branch work together to look at this whole issue and come up with changes that are acceptable to both.”

As soon as tomorrow afternoon votes are expected in the Uruguayan House of Representatives which will cast the country into the lead to become the first country to official end cannabis prohibition.

The country’s president, José Mujica, and the ruling party in the Uruguayan Senate, Frente Ampli, are also public supporters of replacing cannabis prohibition with a state monopoly on cannabis commerce.

[Paul Armentano updates: Uruguay’s lower house late Wednesday night voted 50 to 46 in favor the bill, sending it to the Senate which is also expected to endorse the measure. Read the full story from the New York Times here.]

Having debated Asa numerous times, and having worked with Ethan for twenty years, this is a decidedly unfair debate as Ethan has forgotten more about cannabis policy than Asa will ever know, and Asa brings all of the enthusiasm and intellectual commitment to the debate as a corporate lawyer. His m.o. of parroting DEA-provided talking points is what I find so disappointing ‘debating’ Asa.

Having cannabis legalization debated at this venerable Aspen Institute forum is another socio-political ‘tea leaf’ indicative of the mainstream discussion underway to reform cannabis laws.